Substance Use & Addictive Disorders Require Family Treatment
From the Team at The Family Recovery Institute, San Rafael, CA
At the Family Recovery Institute, we believe that recovery from substance use and addictive disorders isn’t only about the person struggling—it’s about the family. Addiction ripples through relationships, roles, and routines, typically resulting in cycles of loss and despair alternating with periods of hope followed by letdowns, crises and conflicts. When we align the whole family in a shared effort, even one early intervention can help interrupt these disabling cycles – even if the “addict” won’t yet seek recovery.
Why Family-Focused Care Matters
When one person in a family develops an addiction, the entire “family system” is adversely impacted because Addiction is a family disease.
Incidence—around 25% of families include a first-degree member with substance use issues, and roughly 90% of people actively using live with family or partners.
Systemic effects—the family system environment, wounded by addiction and its precursors (typically developmental or ancestral trauma), frequently displays higher than expected levels of disorder, disconnection, danger and denial. Family members cope with life in this environment by escaping, fixing, distracting, blaming or controlling. Feelings of guilt and shame, moments of incomprehensible denial, and the incorporation of enabling behaviors or emotional withdrawal plague the system and worsen over time. All members develop a degree of “Stress-Induced Impaired Coping” the term our Founder Dr. Kenneth Perlmutter has coined and explains in his seminal book, “Freedom from Family Dysfunction: A Guide for Families Battling Addiction and Mental Illness” published by Rowman&Littlefield, 2019 and 2022.
Systems thinking—exploring the family’s strengths and challenges including its relationship to its past and the nature of expectations, communication patterns, agreements, and connections begins the process of harnessing the power of family relationships to support recovery and long-term wellness. For all members,
What Family Treatment Looks Like
FRI offers a flexible menu of therapeutic formats designed to fit each family’s unique dynamics and strengths:
1. Private Family Sessions
Individual (or couple/family) sessions take place in a confidential, safe space—supporting focused exploration of your family’s patterns, communication styles, boundaries, and recovery goals.
2. Therapeutic Groups
Currently we offer two groups for men. One for younger adults and one for all ages. In these weekly sessions issues surrounding substance use, impaired coping and and co-dependency are regularly explored. In addition, our multi-family parent support group, now in its 12th year, meets semi-monthly. Here parents are supported by others who “get” what it’s like to struggle with a problematic child (of any age). Didactic/training sessions alternate with open process-type group therapy.
3. Individual substance abuse, parenting, or co-dependency counseling
The work is especially well supported and gains are achieved more rapidly when one or more members works under or roof in individual psychotherapy. That could be the “addict” or their sibling, parent(s) and/or children (typically 12 and up).
Elements of Family Treatment
Across these offerings, families experience:
Education – Learning how addiction works in the brain, understanding family dynamics, and identifying enabling or co-dependent patterns
Communication Tools – Fostering active listening, tone management, I‑statements, empathy-building, and positive reinforcement. Learning to state one’s needs with less inhibition and worry about effects on others
Boundary‑Setting & Behavioral Plans – Practicing consistent consequences, managing rewarding and problematic events (stimuli), and rewarding recovery‑aligned behaviors
Peer & Coach Support – Families often gain solace and insight from others walking a similar path, plus guidance from an experienced clinician .
Self‑Care Emphasis – Parents, spouses, and children regain a focus on their own emotional, physical, and mental wellbeing. As each members pursues health the systemic environment becomes safer, more secure, and nurturing for all.
Goals & Outcomes
Family systems based therapeutic approaches guide participations to:
Re‑establish trust and honest communication
Disrupt harmful patterns and create healthier dynamics
Empower families to support, not enable, long-term recovery
Build resilience in each family member—so everyone thrives
Connect families with ongoing community and recovery resources
Treat stress-induced impaired coping to guide members and the system as a whole to more sustainable and healthier ways of managing the experience of life in the family thereby creating more of the safety, security and trust all have longed for
Research shows that family therapy leads to better recovery outcomes, lower relapse rates, and improved emotional functioning across generations.
Is Family Therapy Right for You?
Family treatment is ideal for:
Families with active or historical substance use,
Families struggling with enabling, conflict, or breakdown
Loved ones resistant to individual treatment
Families wanting structured tools, education, and a peer community
Anyone ready to transform their family system—even if only one member engages
Getting Started
Initial Consultation
Connect with one of our clinicians to share your story and identify your family’s needs. AsA 15-20 phone conversation is the typical first step and there is no charge for thisCustomized Plan
We’ll build a tailored treatment plan—choosing from private family sessions, individual sessions, and ongoing groups.Therapeutic Work
As the treatment commences, communication exercises, exploring roles and personal histories, boundary-setting, and personal care will be practiced.
Ready to Shift the Story?
Call (415) 322‑0939 or email us today for a free 15‑minute family‑focused consultation: